The scope of an investigation into contacts of a patient with tuberculosis should be expanded if there is evidence that the risk of transmission is greater than normal.
Reasons to expand the scope of the investigation:
(1) unexpectedly high rate of infection in high priority contacts
(2) infection in any contact < 5 years of age
(3) evidence of second generation transmission (medium or high priority contact infecting others)
(4) infection in anyone designated low priority
(5) unexpected high rate of PPD skin test conversion from negative to positive
Expanding the scope of the investigation may include:
(1) inclusion of people with a low priority exposure
(2) increased diligence in following up anyone in the medium or high priority groups
(3) reconsidering the date used as the cutoff for infectiousness
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